The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial
Self-management support for moderate-to-severe chronic obstructive pulmonary disease: a pilot randomised controlled trial.
Better self management could improve quality of life (QoL) and reduce hospital admissions in chronic obstructive pulmonary disease (COPD), but the best way to promote it remains unclear. ⋯ This intervention has good potential to meet the UK National Institute for Health and Clinical Excellence criteria for cost effectiveness, and further research is warranted. However, to make a substantial impact on COPD self-management, it will also be necessary to explore other ways to enable patients to access self-management education.
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Randomized Controlled Trial Multicenter Study
Cardiovascular risk reduction following diagnosis of diabetes by screening: 1-year results from the ADDITION-Cambridge trial cohort.
Uncertainties persist concerning the effects of early intensive management of type 2 diabetes and which patients benefit most from such an approach. ⋯ It is possible to achieve significant reductions in modelled CVD risk over 14 months following diagnosis of diabetes by screening. Risk reduction appeared to be driven mainly by prescription of higher numbers of drugs, decreased energy intake, and weight reduction. There was room for further risk reduction, as many patients were not prescribed recommended treatments.
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Randomized Controlled Trial Multicenter Study Comparative Study
Continuity in different care modes and its relationship to quality of life: a randomised controlled trial in patients with COPD.
New care modes in primary care may affect patients' experienced continuity of care. ⋯ Although personal continuity decreases when new care modes are introduced, no evidence that this affects patients' experienced team continuity or patients' quality of life was found. Patients still experienced smooth, ongoing care, and considered care to be connected. Overall, no evidence was found indicating that the introduction of new care modes in primary care for patients with COPD should be discouraged.
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Randomized Controlled Trial Multicenter Study
A primary care specialist genetics service: a cluster-randomised factorial trial.
GPs do not have the confidence to identify patients at increased genetic risk. A specialist primary care clinical genetics service could support GPs with referral and provide local clinics for their patients. ⋯ An integrated primary care genetics service both supports GPs in appropriate cancer referral and provides care in the right place by the right person.
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Randomized Controlled Trial Multicenter Study
Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
Self-management of hypertension, comprising self-monitoring of blood pressure with self-titration of medication, improves blood pressure control, but little is known regarding the views of patients undertaking it. ⋯ Participants valued the additional information and many felt confident in both self-monitoring blood pressure and self-titrating medication. The reluctance to change medication for borderline readings suggests behaviour similar to the clinical inertia seen for physicians in analogous circumstances. Additional support for those lacking in confidence to implement prearranged medication changes may allow more patients to undertake self-management.